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LigaSure and Hemorrhoids

author image Gary H. Hoffman M.D.
Doctor Hoffman is an experienced colon and rectal surgeon and general surgeon, with 28 years of experience. He is an attending surgeon at Cedars Sinai Medical Center and an instructor in the divisions of colon and rectal surgery and general surgery. Doctor Hoffman is widely published in peer-reviewed publications such as “Diseases of the Colon and Rectum,” “Surgical Rounds” and “American Surgeon.” He is an Editor and frequent contributor to General Surgery News. Dr. Hoffman is a pioneer in the use of the procedure for prolapse and hemorrhoids (PPH), an alternative hemorrhoidal operation which has been demonstrated to result in less postoperative pain and a faster return to work or to the activities of daily living. In his research he has confirmed the superiority of PPH when compared with traditional hemorrhoidectomy. He is actively involved in research to further streamline the procedure and improve the instrumentation. Doctor Hoffman has interests in genetics and hereditary colorectal cancer as well as anal cancer and advances techniques in colonoscopy. Dr. Hoffman is a member of The American Society of Colon and Rectal Surgeons, The Southern California Society of Colon and Rectal Surgeons, The American College of Surgeons and The American Medical Association.
LigaSure and Hemorrhoids
Surgical intervention may be necessary to treat symptomatic hemorrhoids. Photo Credit Keith Brofsky/Stockbyte/Getty Images


Hemorrhoids are collections of anorectal connective tissue, arteries and veins located either inside your anus and rectum or on the skin that surrounds your anus. Hemorrhoidal symptoms can include anal itching, swelling or bleeding. When noninvasive treatments fail to resolve hemorrhoidal symptoms, a surgical approach such as LigaSure may be required.

During a surgical hemorrhoidectomy, the traditional operative treatment for symptomatic hemorrhoids, your physician removes hemorrhoids in an operating room using a scalpel and an electrocautery, a cauterization device. Your recovery from the procedure might include pain, bleeding and time spent away from work and other routine daily activities.

Modern surgical treatments and techniques have made the recovery period shorter and more tolerable. LigaSure is a device that employs the application of energy to obliterate or remove hemorrhoids. The LigaSure device compresses the hemorrhoidal tissue, seals it and then removes any redundant tissue. The reported advantages of LigaSure include less postoperative pain and more rapid resumption of normal activities. The LigaSure technique is best performed by a specialist with experience in using the device.

Your physician may choose to use a harmonic scalpel in a manner similar to the LigaSure procedure. The harmonic scalpel procedure seals and cuts hemorrhoidal tissue using a slightly different principle to obtain the same result -- namely, the destruction of the symptomatic tissue.

The procedure for prolapse and hemorrhoids, or PPH, involves the surgical stapling of hemorrhoids. As with LigaSure, the recovery from PPH is faster and less painful than that of a traditional surgical hemorrhoidectomy. Other techniques, including infrared coagulation, rubber banding and Doppler-guided hemorrhoidal artery ligation have been used for many years and also are effective in treating symptomatic hemorrhoidal tissue.

Researchers have performed numerous studies examining the effectiveness of hemorrhoidal surgical techniques. As expected, the results have not produced a clear-cut winner; each procedure has its pros and cons. One thing is clear; surgical interventions always should be performed by a specialist trained and experienced in the field of colon and rectal surgery. Always consult a colon and rectal specialist to discuss available treatment options for your symptoms. Never self-diagnose. Your physician will perform a thorough evaluation to rule out the possibility of a more serious disease.

Ask your doctor about his or her experience using any recommended technique, and be sure you are comfortable with the suggested treatment plan before embarking on any operative procedure.


Dr. Hoffman does not endorse any products seen on this website.

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